Neonatal ping pong fracture - Swiss Society of Neonatology

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DISCUSSION too invasive and wanted to look for an alternative way to treat this greenstick fracture. The baby was dischar- ged after a three-day-hospitalization. Based on this case we would like to take the opportu- nity to discuss etiology, diagnostic evaluation, therapy and outcome of congenital depression fractures of the skull. Traumatic injury to the skull and brain in utero is rare (1) and rarely needs intervention or causes persistent disability ( , ). Birth injury falls into categories: A) injuries produced by the normal force of labour and B) those produced by obstetric interventions. The inci- dence is higher in the instrumental deliveries and signi- ficantly more likely to be associated with intracranial lesions. The ping pong skull fracture is a green stick fracture of the skull, it occurs when the skull bones are still soft, thin and resilient. It presents as a depression de- formity of the skull – similar to a dent in a ping pong ball – with no fracture line seen radiologically. It is thought that a ping pong fracture results from the pressure of the ischial tuberosity or sacral promontory symphisis pubis against the soft skull during labor ( ). Associated intracranial injuries are rare. This condition can be diagnosed clinically. Plain x-ray may show the degree of deformation. An ultrasound of the skull is 4
5 Ping pong fracture in the left temporo-parietal region (arrow heads). Fig. 1
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Page 9 and 10: 9 Cerebral ultrasound: Ping pong fr
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Neonatal ping pong fracture - Swiss Society of Neonatology

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